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Case summary
Age: 59 year old
Gender: male
Type II DM treated with oral drugs
Hypertension; Dyslipidemia
Morbidity obese (BMI 35)
Previous smoking habit
2009: CABG with LITA on LAD, SVG on D1, SVG on MO1, SVG on PDA
Stable angina (CCS III)
Nuclear perfusion imaging: severe ischemia on inferior and anterior wall
Occluded LITA; occluded all SVG
LAD: proximal occlusion
MO1: ostial occlusion
RCA: mid occlusion
SYNTAX score: 25 (RCA CTO 10pts)
JCTO score 2: calcium and >20 mm
Strategy
ACCESSES:
Radial XB 3.5 6Fr 90 cm
Femoral AL1 7Fr 100 cm; long sheath
APPROACHES:
Antegrade approach with guidewire escalation (starting with GAIA 3rd); Turnpike Gold microcatheter
Antegrade dissection reentry
Retrograde approach
Protocol
OptiRAY® (ioversol)
Concentration : 350 mgI/mL
Volume : 420mL
Shooting date : 2017-01-26
Last update : 2021-06-09
Last update : 2021-06-09
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Retry of an ostial LAD CTO, previous antegrade failure with Gaia family
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Monday, September 26th 2022 from 05pm to 07pm (GMT+2)
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30 Years of Transradial Access:
Pushing the boundaries in cardiology & beyond
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May 2017
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Discussion around complex PCI
How to deal with complications?
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Benefits of Mechanical Circulatory Support devices
Swiss Case Club
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Bifurcation PCI: an immersive experience
Live cases from the Visible Heart® Lab
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